Correspondence |

Therapeutic Effect of Clopidogrel on Cutaneous Polyarteritis Nodosa

Tamihiro Kawakami, MD, PhD; Yoshinao Soma, MD, PhD
Arch Dermatol. 2010;146(1):100-101. doi:10.1001/archdermatol.2009.349.
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Clopidogrel is a drug in the recently developed class of thienopyridine derivatives used to block adenosine diphosphate receptors on platelets, a blockade that results in the inhibition of platelet aggregation.1 The current use of clopidogrel is mainly to prevent stent restenosis in coronary artery disease and in the early and long-term prevention of atherothrombotic events.

Rousseau  PTartas  MFromy  B  et al.  Platelet inhibition by low-dose aspirin but not by clopidogrel reduces the axon-reflex current-induced vasodilation in humans. Am J Physiol Regul Integr Comp Physiol 2008;294 (5) R1420- R1426
Kawakami  TYamazaki  MMizoguchi  MSoma  Y High titer of anti-phosphatidylserine–prothrombin complex antibodies in patients with cutaneous polyarteritis nodosa. Arthritis Rheum 2007;57 (8) 1507- 1513
Maree  AOFitzgerald  DJ Variable platelet response to aspirin and clopidogrel in atherothrombotic disease. Circulation 2007;115 (16) 2196- 2207
Heitzer  TRudolph  VSchwedhelm  E  et al.  Clopidogrel improves systemic endothelial nitric oxide bioavailability in patients with coronary artery disease: evidence for antioxidant and antiinflammatory effects. Arterioscler Thromb Vasc Biol 2006;26 (7) 1648- 1652
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Figure 2

In case 2, examination revealed erythematous macules, purpuric lesions, and nodules scattered over the extremities.

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Figure 1

In case 1, infiltration of the arterial wall predominantly by neutrophils induced destructive and occlusive changes in the subcutaneous fat. Fibrinoid degeneration was also seen (hematoxylin-eosin, original magnification ×20).

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